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44441 16th St W Ste 103 Lancaster CA 93534-2873 | |
| (661) 945-4040 | |
| (661) 945-9120 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 44441 16th St W Ste 103, Lancaster, California |
| Authorized Official Name and Position | Gennady Landa (PRESIDENT) |
| Authorized Official Contact | 8189700253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
44439 17th St W Ste 102 Lancaster CA 93534-2854 Ph: (661) 945-4040 | 44441 16th St W Ste 103 Lancaster CA 93534-2873 Ph: (661) 945-4040 |
| NPI Number | 1356834675 |
|---|---|
| Provider Enumeration Date | 06/12/2018 |
| Last Update Date | 12/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356834675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (California) | Primary |
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